Summer Fun Camp 2017

Empower Youth Club Registration Summer Camp 2017
Welcome to our exciting, action-packed full day Soccer and Cheerleading Camps. We cater to boys and girls ages 5-12 years. Campers participate in fun activities that help build physical endurance, coordination, strength, self-esteem and teamwork.

Soccer campers learn skills necessary to be successful, confident players. Skills include dribbling, passing, scoring, offense, defense, small sided-games, and various tricks.

Cheerleading campers learn cheers, chants and a choreographed dance routine while enjoying arts and crafts.

During the day, all campers head over to the playground for supervised free-play. This gives them an opportunity to meet and socialize outside of their camps.

Are you ready campers? We'll have an awesome week of fun in the sun!
La Romeria Park

19501 Inglewood Ave

Torrance, CA 90503

June 26 - June 30, 2017

9 am - 3 pm

Choose camp(s). Price includes t-shirt and medal.

Summer Soccer Camp 6/26-6/30 (Deadline 6/19) $ 225.00

Quantity

Summer Cheerleading Camp 6/26-6/30 (Deadline 6/19) $ 225.00

Quantity

Total: $ 0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Camper Information
Child #1 Name *

First Name Last Name
Grade in Fall 2017 *
Age *
Gender *

Male Female
School *
T-Shirt Size *

XS S M L
Child #2 Name

First Name Last Name
Grade in Fall 2017
Age
Gender

Male Female
School
T-Shirt Size

XS S M L
Parent Information
Parent *

First Name Last Name
Phone Number *

- Area Code Phone Number
E-mail *
Emergency/Medical Information
Emergency Contact *

First Name Last Name
Emergency Contact Phone Number *

- Area Code Phone Number
Please list food allergies, physical limitations, or any other known condition we should be aware of. *
Liability/Photo/Video Release
I voluntarily agree to assume all risks and responsibility for injury or accident, which might occur to me or my minor child during any of Empower Youth Club’s classes, rehearsals, performances, or activities. I assume all risks related to the use of facilities or equipment used by Empower Youth Club. I also voluntarily exempt, release, and indemnify Empower Youth Club, its Directors, Officers, employees, independent contractors and volunteers from any and all liability claims, demands, or causes of action from any damage, loss, injury, or death to me, my minor child, or property in connection with participation in classes or activities conducted by Empower Youth Club, its Directors, Officers, employees, independent contractors and volunteers. I further hereby voluntarily agree to waive my rights and that of my heirs and assigns to hold Empower Youth Club, its Directors, Officers, employees, independent contractors and volunteers liable for such damage, loss, injury, or death.

I consent and agree that Empower Youth Club has the right to take photographs and videos of my child and use these on the company website (www.empoweryouthclub.org), social media sites, and promotional material without compensation. Your child’s identity will not be revealed. If you would not like your child photographed or videoed, please notify us via email at info@empoweryouthclub.org.
Attendance and Refund Policy
Attendance & Dismissal Policy
- Parents must sign in and sign out campers each day.
- Campers will be released to parents/guardians on the registration form.
- Please notify EYC or the Coach of a camper's absence.
Refund Policy:
- An 80 % refund is granted when notice is given to Empower Youth Club on or before the registration deadline of your chosen camp. A 50% refund is made if notice is given after the deadline, but prior to the first day of camp. No refunds will be issued once the camp starts.
- There are no refunds for t-shirts, medals or cheer bows nor credits or refunds for missed classes.
- Refunds take 2-4 weeks to process.
Make-Up Classes & Cancellation Policy:
- We use outdoor space. If weather does not allow us to conduct camp, and indoor space is unavailable, a make-up camp day will be scheduled. In some cases, a credit or refund will be issued for that particular day. All parents will be notified.
- Camp may be cancelled due to insufficient enrollment. All parents will be notified and a full refund will be issued. Refunds take 2-4 weeks to process after the camp is cancelled.
- If camp is cancelled for other reasons, the refund will be based on number of camp days left in the session.
Electronic Signature: By entering my name below, I accept the above conditions and releases. *

First Name Last Name
Relationship to Camper
Date

- Month - Day Year
Should be Empty:

Empower Youth Club Registration Summer Camp 2017

Camper Information

Parent Information

Emergency/Medical Information

Liability/Photo/Video Release

Attendance and Refund Policy